DESCRIPTION: The purpose of this study is to reduce blood-borne infections among home health care nurses by preventing occupational blood exposure. Development of programs for preventing blood exposure in these workers is hampered by a severe lack of information. This study will provide needed information in four critical areas: the magnitude of the problem; nurse-, patient-, employer-, and work environment-related risk factors for exposure; the extent to which current prevention programs are being implemented, and their impact; and directions for new prevention strategies. Data for this study will come from a national survey of home health care nurses. The Specific Aims are as follows: 1. Derive national incidence rates for occupational blood exposure in home health care nurses in the US. 2. Identify risk factors for blood exposure among home health care nurses and quantify their effects. 3. Quantify the availability and use of medical safety devices, and identify and quantify their determinants. 4. Characterize blood exposure events to identify incident-related factors associated with exposure. 5. Identify potential strategies for prevention of blood exposure among home health care nurses. The nurses will be selected in a two-stage design in which home health care agencies are selected in the first stage and home health care nurses are selected in the second stage. A commercially available list of all US home health care agencies will be used to select a sample of 500 agencies, from which 3,000 nurses will be selected. The questionnaire will be based on the instrument from a recently conducted similar study of paramedics, and will be improved based on the lessons from that study. The questionnaire items will relate to specific risk-relevant features of home health care nurses' work, e.g., poor lighting or uncontrolled children in the home. Collaborating agency directors and home health care nurses, focus groups, and a pilot study will be used to design and test recruitment strategies that will ensure high response rates. [unreadable] [unreadable]